Masks key flu protection for health workers: report

WASHINGTON (Reuters) - Doctors, nurses and other healthcare workers taking care of people infected with the new swine flu should wear special masks known as respirators, but need to protect themselves in other ways, too, according to a report released on Thursday.

The Institute of Medicine stressed that scientists still do not know much about how influenza viruses are transmitted, and that healthcare workers in general are bad at protecting themselves and their patients against such infections.

While recommending more research into how flu is transmitted and the best defenses against it, the expert committee said in the meantime workers should at least wear a special respirator in addition to washing hands and taking other measures against infection.

A N95 respirator covers the nose and mouth tightly, filtering out tiny particles that can carry viruses and bacteria. It is different from a surgical mask, a loose covering that lets air in at the sides and which is used to protect patients from the people treating them.

"Healthcare workers (including those in non-hospital settings) who are in close contact with individuals with nH1N1 (the new pandemic H1N1) influenza or influenza-like illnesses should use fit-tested N95 respirators," the report reads.

"Healthcare organizations and workers need consistent and clear nH1N1 guidelines that can be implemented across all healthcare facilities."

H1N1 swine flu, declared a pandemic in June, is spreading fast and experts expect it to infect more people as schools reopen and temperatures fall in the Northern Hemisphere's autumn.

A vaccine will not be available in most countries until October. The U.S. Centers for Disease Control and Prevention has recommended that healthcare workers wear N95 masks to protect themselves when treating patients suspected of having H1N1. The Institute of Medicine panel, headed by Dr. Kenneth Shine of the University of Texas at Austin, agreed.

But it also said the CDC, the National Institutes of Health, and agencies need to work more to find out how flu is transmitted.

Experts agree that influenza viruses spread on pieces of mucus and saliva, called fomites, that can travel a few feet (about a metre) through the air and quickly settle onto surfaces, and that they may also be airborne on smaller particles that stay in the air longer.

But it is not clear which route of transmission is the most common.

The report also notes that while healthcare workers know this, they do not wear masks, respirators or wash their hands anywhere near as often as they should. And only about 40 percent get vaccinated against seasonal influenza, even though it is widely agreed this is the best protection.

Thus, they not only risk infecting themselves, but their patients.

The Services Employees International Union, which represents healthcare workers, welcomed the report.

"We are hopeful this will lay to rest once and for all any remaining doubts on the need to take these reasonable steps to protect healthcare workers if we expect them to be there for their patients during this pandemic," Bill Borwegen, of the SEIU said by e-mail.